Issues of diagnosis and care for the transgender patient: is the DSM-5 on point?

The experience of individuals who happen to be transgender is one that reflects a complex constellation of powerful influences both within and outside of the health care system in the United States. Profound stigma, prejudice, misunderstanding, and hate for these individuals are just a few examples of the formidable challenges that potently shape their lives. The combination of exposed vulnerabilities in the expression of their true selves, and the often hostile environment where this transformation occurs creates the perfect storm for the onset of serious psychiatric illnesses. Oddly enough, the pathology is often not wrought in the experience of the genuine self but more so in what happens to that self in the context of a violent environment. This article explores these factors in the context of psychiatric diagnosis in the DSM-5.